Finger Injuries, and splinting
Boutonniere deformity
DIP in hyperextension, should be splinted with DIP and PIP in extension
Boutonniere deformity
DIP joint is brought into hyperextension while the PIP joint is flexed past normal ROM
OPQRST, Last oral intake, Exposure to illness, Bowel/bladder, Family history
History questions for the chest include? (5)
Ape Hand
If an athlete has an inability or weakness to flex or oppose the 1st MCP/IP joints, which of the following conditions are possible?
Rib Fx.
MOI for this injury is acute compression, symptoms include pain, difficulty breathing, pain w/breathing/compression. Tests include rib compression test ddx includes costochondral injury, pnemothorax, hemothroax, flail chest
Kidney contusion/laceration
MOI for this injury is acute trauma, main symptoms include hematuria, tenderness/ridgity over site, and signs of shock
Hemothorax/Pneumothorax
MOI of this injury is direct or indirect trauma, includes symptoms of rapid shallow breathing, distended veins, deviated trachea, abscense of breath sounds, cyanosis, dizziness, SOB, labored breathing, decreased BP, and hemaptysis
jersey finger
Splinting should be done in flexion and referred to an orthopedic
External intercostals, abdominals
What are the expiration muscles ? (2)
intercostals, scalenes, serratus anterior, pec minor, diaphragh
What muscles help breath air in? (5)
Jersey finger
avulsion of the flexor digitorum profundus tendon off the palmar aspect of the DIP joint, causes inability to flew disal phalanx (happens to athlete who tries to hold opponents jersey and gets it pulled back into extension)
Dupuytren's contracture
disease that is common in men ages 40+, its hereditary, there is abnormal thickening of the tissue just beneath the skin, typically starts in the palm and extends to the fingers, there is a contracture of the MCP and PIP joints
Claw hand
extended MCP joint, flexed DIP and PIP joint (caused by congenital abnormality, burns to forearm, nerve palsy)
Swan neck deformity
finger with a hyperextended PIP joint and a flexed DIP joint (90 degree deformity, normal bending impossible)
Mallet finger
flexion of DIP joint (caused by Extensor tendon rupture or avulsion of the tendon from the phalange)
bishop's deformity
hyperextension of MCP joint and flexion of IP joints 4th & 5th (caused by ulnar neuropathy on the hypothenar eminence)
De Quervain's syndrome
injury caused by repetitive stress which causes compartment to become inflamed, tenosynovitis of extensor pollicis brevis and abductor pollicis longus tendons. Thickening and narrowing of tendon sheaths, common in women between 20-40
Commotio Cortis
injury is caused by direct trauma prior to T wave, .1 second window, includes an arrhythmia, and AED is used to treat it
appendix
referred pain site is McBurneys
spleen
referred pain site is kohr's sign
kidney
referred pain site is the lower back
gall bladder
referred pain site is the right scapula
liver
referred pain site is the upper right shoulder
MOI for Swan neck deformity
rheumatoid arthritis, finger tendon rupture, misalignment of the healing of a fx.
PIP and DIP in extension
splinting of Boutonniere deformity
position found
splinting of a Phalanx fx.
palmar surface of hand/wrist
splinting of metacarpal fx.
DIP in extension
splinting of the Mallet finger
position found
splinting of unreduced dislocation
Dupuytren's disease/contracture
this disease can be tx. by tabletop tests, needling, enzyme injections, surgery, splinting, hand therapy
Splenic injury
this injury is caused by direct trauma or increased abdominal pressure and has symptoms of kehr's sign and signs of shock
acute-surgery, chronic-can't fix
treatment of acute or chronic bishop's deformity (2)
surgery, splinting, physical therapy
tx. for swan neck (3)
Ape hand
tx. for this injury is RICE, possible surgery, rest, physical therapy
DeQuervain's syndrome
tx. for this injury is corticosteriod injection, RICE, splinting to limit ulnar deviation, surgery to release sheaths surrounding tendons
NSAIDs, immobilization, corticosteroid injection, PT
tx. of claw hand
